Provider Demographics
NPI:1639897804
Name:CHAVEZ, HECTOR H JR
Entity type:Individual
Prefix:MR
First Name:HECTOR
Middle Name:H
Last Name:CHAVEZ
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14510 MONTANA AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79938-7203
Mailing Address - Country:US
Mailing Address - Phone:915-996-7505
Mailing Address - Fax:
Practice Address - Street 1:14510 MONTANA AVE STE 101
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79938-7203
Practice Address - Country:US
Practice Address - Phone:915-996-7505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-15
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX85546101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health